A California appellate court has declared physician Visha Dev the loser in his dating contest with Blue Shield Life and Blue Shield California. The contest arose when the Blues moved for summary judgment in Dev’s action against them for denying three reimbursement claims. The Blues argued that the date when …
DOJ Antitrust Head Remains Focused on Health Care in Era of Consolidation
November 16, 2015 Leave a Comment
Speaking at an industry conference on November 13, U.S. Assistant Attorney General Bill Baer reiterated the government’s focus on competition concerns in the health care industry. According to Baer, head of the Department of Justice’s Antitrust Division, while the Affordable Care Act (ACA) “promotes …
Health Facilities May Be Insuring Doctors without Knowing It
October 7, 2015 Leave a Comment
A September 29 ruling by the New Jersey Supreme Court effectively makes a health facility liable for the professional negligence of a medical staff member who doesn’t have malpractice insurance or who has insurance that doesn’t cover the acts in question. Dr. Kaul performed a spinal fusion on Jim Jarrell at …
Fitbit Agrees to Sign Business Associate Agreements and Take on HIPAA Compliance
September 21, 2015 Leave a Comment
Is your Fitbit data covered by HIPAA? It depends upon where you got it (kind of). If you go to the store and pick up a Fitbit on your own, the data it generates is governed by the user agreement that you click through (which I’m sure everyone read carefully). If your health plan or employer, through its …
Two More Hospitals Qualify for Exception to Exception to Grandfather Exception to Elimination of Whole Hospital Exception to Stark Law Prohibition
September 17, 2015 Leave a Comment
The Stark Law generally prohibits physicians from referring Medicare and Medicaid patients to facilities in which they have an ownership interest. There used to be a “whole hospital exception” excluding entire hospitals (as contrasted to departments or parts of hospitals) from the prohibition. The …
Third Cir. Holds Hospitals May Sue Health Insurers Directly
September 14, 2015 Leave a Comment
Before September 11 the Third Circuit Court of Appeals had been out of step with its sister federal circuits when it came to the right of hospitals, physicians and other health providers to sue health insurers that failed to cover patient obligations. So back in 2014 when North Jersey Brain & Spine Center …